Stroke, also known as stroke, is an acute cerebrovascular disease that includes ischemic and hemorrhagic strokes, with most stroke patients suffering from hemorrhagic strokes. Stroke has become the leading cause of death and disability in the global population. Approximately 75% of surviving patients have varying degrees of functional impairment.
According to the survey, one Chinese person has a stroke every 12 seconds, and one Chinese person dies of a stroke every 21 seconds.
Rehabilitation goals
1. Restoration of function. It means that if a stroke patient has functional
If the stroke patient has functional impairment, such as motor impairment, swallowing impairment, speech impairment, psychosocial impairment, cognitive impairment, etc., it can be restored through targeted rehabilitation training.
2. Improve the patient’s ability to take care of himself/herself. Patients can complete some basic activities of life independently. Our motor function, communication function, etc. are all for the purpose of daily
life. In this way, the patient can manage his own life, which can improve his quality of life significantly.
3. Restoration of social participation. Restoration of social participation is more important for patients who are of working age and younger, because of the low age of stroke, which makes it more and more demanding. The ultimate goal is to enable the patient to return to work and be able to support not only himself but also his family.
Training methods
1.Active movement
When the affected limb can be lifted actively, the training should be focused on correcting abnormal posture. This is because post-stroke limb paralysis is accompanied by abnormal movement patterns in addition to reduced strength, which is the common posture of “basket on the upper limb and circle on the lower limb”.
2.Sit up training
Sitting is the most basic training for walking and daily life. If the patient can sit up, it can bring great convenience for eating, urinating and defecating, and upper limb movement.
3.Preparation training before standing
The patient sits on the edge of the bed with legs apart and both feet on the ground, supports the bed with hands, and slowly tilts the body to the left and right with the support of the upper limbs. Each lift should be held for 5~6 seconds.
4.Standing training
When training, family members must pay attention to the patient’s standing posture, so that his feet stand parallel to each other with a fist distance between them, the knee joint cannot be bent or overly straightened, the palms of both feet are completely on the ground, and the toes cannot be hooked to the ground. Practice for 10~20 minutes each time, 3~5 times a day.
5.Walking training
For patients with hemiplegia, walking training is more difficult, so family members should give confidence and encourage patients to persist in exercising. With the assistance of family members, two people should walk the lateral lower limb first and then the medial lower limb. If the affected limb has difficulty in stepping forward, you can start by stepping in place and gradually practice walking slowly, and then train to walk independently. The lower limb of the family can carry the patient’s affected limb to step forward, 5-10 meters each time.
6.Up and down step training
After walking on a flat road to practice balance, you can practice going up and down steps. At the beginning, someone must protect and assist.
7.Training of trunk core strength
Such as rolling over, sitting up, sitting balance, bridge exercise and other movement exercises are also important to improve trunk stability and lay a good foundation for standing and walking.
8.Language training
Some stroke patients, especially those with right-sided hemiplegia, often have language comprehension or expression problems. Family members should strengthen non-verbal communication with the patient at an early stage, such as smiling, touching, hugging, and starting with the patient’s most concerned issues to stimulate the patient’s desire to speak. Language practice should also follow the principle of gradual progress, starting with [a], [i], [u] pronunciation and whether to express, and nodding and shaking the head instead of voice expression for severe aphasia.
Stroke misconceptions
1. As long as you rely on medication and can rest well, you can gradually recover and do not need rehabilitation. However, there is a fundamental difference between rehabilitation and medication. The purpose of rehabilitation is to restore the lost function of the patient, not by medication, but by rehabilitation through various exercise therapies.
2. For the treatment of stroke hemiplegia, acupuncture and massage in Chinese medicine are sufficient. In fact, acupuncture and massage do play a vital role in Chinese medicine, but they are not all of the rehabilitation treatment, but only a small part of the rehabilitation process, and should not be equated with rehabilitation.
3. As long as the patient is well taken care of, he or she can recover quickly. Research studies show that patients in families with more members are relatively less able to live. The fact that others take good care of the patient may cause the patient’s own awareness of rehabilitation exercises to be weak. Therefore, family members should establish a sense of rehabilitation and try to enable patients to do what they can.
4. Just let the patient practice walking more often. Rehabilitation is a systematic process that requires continuous development and modification of rehabilitation training programs according to the patient’s condition. Walking is not suitable for all hemiplegic patients, and it is important to distinguish between soft and hard palsy.